Online Application Handbook 07-2017 - Virginia 16 If you select “YES ... select “Yes” or...

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ONLINE

APPLICATION

HANDBOOK

VIRGINIA BOARD OF SOCIAL WORK

The DHP mission is to ensure safe and competent patient care by licensing health professionals,

enforcing standards of practice, and providing information to health care practitioners

and the public.

PERIMETER CENTER

9960 MAYLAND DRIVE

SUITE 300

HENRICO, VA 23233-1463

T E L : ( 8 0 4 ) 3 6 7 – 4 4 4 1

F A X : ( 8 0 4 ) 5 2 7 – 4 4 3 5

NOTE: The information contained in this handbook is subject to change at any time.

All current information can be found at http://www.dhp.virginia.gov/social

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Table of Contents

REGISTRATION OF SUPERVISION INITIAL APPLICATION ...................................................................3

REGISTRATION OF SUPERVISION ADD/CHANGE APPLICATION......................................................11

LICENSED SOCIAL WORKER BY EXAM APPLICATION .......................................................................18

LICENSED SOCIAL WORKER BY ENDORSEMENT APPLICATION .....................................................27

LICENSED CLINICAL SOCIAL WORKER BY EXAM APPLICATION ...................................................37

LICENSED CLINICAL SOCIAL WORKER BY ENDORSEMENT APPLICATION .................................47

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Registration of Supervision toward LCSW Licensure

INITIAL APPLICATION

Please review the Licensure Process Handbook and Regulations Governing the Practice of Social Work

prior to submitting an application for supervision.

Step 1

Visit http://www.dhp.virginia.gov/social/social_forms.htm for the “Applications and Forms” for the

Board of Social Work and select “Click here to begin” in order to access the application.

Step 2

Refer to the distinctions between each license on the website.

Note: All application fees are non-refundable; therefore, it is important that you select the correct

application.

Step 3

Once you have established which application you will submit, select “Click here to begin” at the bottom

of the page to begin the application.

Guide Continues on Next Page

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Step 4

If it is the first time that you are accessing the application, select Register a Person in the upper left

corner.

Note: If it is not your first time accessing the application, simply enter your User ID and Password into

the designated boxes.

Step 5

After selecting “Register a Person,” enter your last name and Social Security Number in the provided

boxes at the bottom of the page and click “Search.”

Step 6

Once you have registered for the application, you will be brought to the Initial Applications Page. Select

“Initial Application” in the upper left hand corner.


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Step 7

For the category “Profession”, select “Social Work.”

Step 8

For the category “License Type”, select “Registration of Supervision.”

Step 9

If it is the first time that you are registering supervision with the state of Virginia, then for the category

“Obtained by Method”, select “Initial Application.”

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Step 10

IMPORTANT: In the middle of the page, select “CLICK HERE” in order to access the supporting

documentation that is necessary to complete your application following the submittal of your online

application.

Note: Incomplete applications will not be processed.

Step 11

Be sure to thoroughly read the instructions provided, then click the Start button at the bottom of the

page.

Step 12

Enter your personal information as requested by the categories to the left of the input boxes. Asterisks to

the right of the input boxes indicate required fields.

Note: The address provided in this section is subject to disclosure under the Freedom of Information Act

(FOIA).

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Step 13

Enter your address of record. This is considered a private, undisclosed address used for billing and

records with the board.

Step 14

Using the input fields, enter your proposed supervised experience. You will be prompted to enter the

name of your proposed supervisor, your supervisor’s license number, the name of the work site that your

hours will be obtained while under supervision, the address of the site, the telephone number of the site,

and your job title while under supervision.

Step 15

Using the drop down menu, indicate whether or not this is your initial LCSW Registration of

Supervision application.

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Step 16

If you select “YES,” you will be prompted to enter the name of each educational institution that you

have attended after high school, as well as the type of degree which you received from that institution.

Please list this information in chronological order. Click “Add” in order to add each institution to your

application. If you selected “NO,” then you can proceed to the next step.

Step 17

Using the drop down menu, indicate whether or not this is your initial LCSW Registration of

Supervision application.

Step 18

If you select “YES,” then you will be prompted to answer about the practicum experience that you

received during graduate school. Please list this information in chronological order. Click “Add” in

order to add each institution to your application. If you selected “NO,” then you can proceed to the next

step.

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Step 19

Using the drop down menus for each question, select “Yes” or “No” to answer each question provided.

With exception to the final question regarding military spouses, each question answered with YES will

require you to enter contextual information and/or provide additional documentation regarding the

nature of the incident. Please see the Board’s Guidance Document available on the website for more

information.

Note: Failure to disclose any information related to these questions may be grounds for denial,

reprimand, or imposition of terms, suspension or revocation of your license and/or registration.

Step 20

Review the information that you have submitted by scrolling through the summaries of each section that

you completed. Use the back button to edit any information that may be incorrect.

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Step 21

Type your name for the electronic signature and mark that you agree to the certification. Then select

“Finish” when you are ready to submit your application.

Note: You do not need to send a copy of your online application with your supporting documentation.

Step 22

Be sure to complete the Workforce Survey, found in the top left of the initial application page, which

can be accessed at the end of the Application Process, and then proceed to finish the application and pay

your processing fee.

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Registration of Supervision toward LCSW Licensure

ADD/CHANGE APPLICATION



Step 1



Step 2



application.

Step 3




12

Step 4


corner.



Step 5



Step 6




13

Step 7


Step 8

For the category “License Type”, select “Registration of Supervision.”

Step 9

If it is the first time that you are registering supervision with the state of Virginia, then for the category

“Obtained by Method”, select “Add/Change.”

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Step 10



application.


Step 11


page.

Step 12




(FOIA).

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Step 13



Step 14

Using the input fields, enter your proposed supervised experience. You will be prompted to enter the

name of your proposed supervisor, your supervisor’s license number, the name of the work site that your

hours will be obtained while under supervision, the address of the site, the telephone number of the site,

and your job title while under supervision.

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Step 15





information.



Step 16



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Step 17




Step 18




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LICENSED SOCIAL WORKER

BY EXAM APPLICATION



Step 1



Step 2



application.

Step 3




19

Step 4


corner.



Step 5



Step 6




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Step 7


Step 8

For the category “License Type”, select “Licensed Social Worker.”


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Step 9

For the category “Obtained by Method”, select Examination.

Step 10



application.


Step 11


page.

22

Step 12




(FOIA).

Step 13



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Step 14

Using the drop down menu, select “Yes” or “No” if you are applying with a MSW degree.

If you selected “No,” then use the drop down menu to select “Yes” or “No” if you are applying with a

BSW degree.

Step 15

Use the drop down menu to indicate whether you have ever been issued a license or certification to

practice social work in any jurisdiction (whether current, expired, inactive, etc).

Note: List in order of attainment all the states in which you now hold or have ever held an occupational

license or certificate to practice as a social worker. For each license or certificate indicated, whether

current or lapsed, you must submit a Verification of Licensure form completed by the issuing jurisdiction.

If you select “Yes,” you will be prompted to enter the jurisdiction in which you were issued your license

as well as the number of that certification or license.

If you select “No,” you can simply move on to the next step.

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Step 16





information.



Step 17

Use the input fields to list in chronological order your complete Behavioral Health related professional

experience after receiving your social work degree. List present position first and date back to your

degree. You will be prompted to enter your employer’s name, their address, your start and end dates,

and your job title and type.

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Step 18



Step 19





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Step 20




27

LICENSED SOCIAL WORKER

BY ENDORSEMENT APPLICATION



Step 1



Step 2



application.

Step 3




28

Step 4


corner.



Step 5



Step 6




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Step 7


Step 8

For the category “License Type”, select “Licensed Social Worker.”

Step 9

For the category “Obtained by Method”, select Endorsement.

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Step 10

For the category “Country”, select the country in which you obtained your previous social work license.

Step 11

For the category “State/Province”, if your previous license was obtained in the United States, select the

state in which you received the license.

Note: You should choose the jurisdiction where you were recently licensed comparable to the type of

license in which you are applying.

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Step 12



application.


Step 13


page.

Step 14




(FOIA).

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Step 15



Step 16









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Step 17

Using the drop down menu, select “Yes” or “No” if you are applying with a MSW degree and if you are

able to provide verification of a passing score on the ASWB examination.

If you selected “No,” then use the drop down menu to select “Yes” or “No” if you are applying with a

BSW degree and if you are able to provide verification of a passing score on the ASWB examination.

Step 18

If you are not applying with either a Master’s or Bachelor’s of Social Work, follow the instructions

provided in order to continue with the application.


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Step 19

You will be prompted to enter the name of each educational institution that you have attended after high

school, as well as the type of degree which you received from that institution. Please list this information

in chronological order. Click “Add” in order to add each institution to your application

Step 20





information.




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Step 21

Use the input fields to list in chronological order your complete Behavioral Health related professional

experience after receiving your social work degree. List present position first and date back to your

degree. You will be prompted to enter your employer’s name, their address, your start and end dates,

and your job title and type.

Step 22



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Step 23




Step 24




37

LICENSED CLINICAL SOCIAL WORKER

BY EXAM APPLICATION



Step 1



Step 2



application.

Step 3




38

Step 4


corner.



Step 5



Step 6




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Step 7


Step 8

For the category “License Type”, select “Licensed Clinical Social Worker.”


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Step 9

For the category “Obtained by Method”, select Examination.

Step 10



application.


Step 11


page.

41

Step 12




(FOIA).

Step 13




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Step 14









Step 15

Using the drop down menu, indicate whether or not you have completed the required post-master’s

degree experience toward licensure as outlined in the Regulations Governing the Practice of Social

Work.

Note: Do not continue with this application if you have not received the adequate experience for

licensure as in the Regulations Governing the Practice of Social Work.

All application fees are non-refundable.

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Step 16

Using the drop down menu, indicate whether or not this is the first time that you have submitted for an

LCSW license in the state of Virginia (without Virginia approved Registration of Supervision).

If you select “Yes,” you will be prompted to enter the name of each educational institution that you have

attended after high school, as well as the type of degree which you received from that institution. Please

list this information in chronological order. Click “Add” in order to add each institution to your

application.

If this is not your first time applying for licensure or supervision, simply select “No” and move to the

next step.

Step 17

Using the drop down menu, indicate whether or not this is the first time that you have submitted for an

LCSW license in the state of Virginia (without Virginia approved Registration of Supervision).

If you select “Yes,” you will be prompted to indicate the field instruction you received while in graduate

school. Please list this information in chronological order. Click “Add” in order to add each institution

to your application.

If this is not your first time applying for licensure or supervision, simply select “No” and move to the

next step.

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Step 18





information.



Step 19

Indicate the hours of supervision that you have completed by entering the name of your supervisor,

beginning and end dates of your supervision, the site where your supervision was completed, your

supervisor’s license type, and in what state your supervisor is licensed.

Note: If you were supervised during more than length of time, or with multiple supervisors, you should

include all instances.

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Step 20



Step 21





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Step 22




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LICENSED CLINICAL SOCIAL WORKER

BY ENDORSEMENT APPLICATION



Step 1



Step 2



application.

Step 3




48

Step 4


corner.



Step 5



Step 6




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Step 7


Step 8

For the category “License Type”, select “Licensed Clinical Social Worker.”


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Step 9

For the category “Obtained by Method”, select Endorsement.

Step 10

For the category “Country”, select the country in which you obtained your previous social work license.


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Step 11

For the category “State/Province”, if your previous license was obtained in the United States, select the

state in which you received the license.

Note: You should choose the jurisdiction where you were recently licensed comparable to the type of

license in which you are applying.

Step 12



application.


Step 13


page.

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Step 14




(FOIA).

Step 15



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Step 16

List in order of attainment all the states in which you now hold or have ever held an occupational license

or certificate to practice as a social worker. For each license or certificate indicated, whether current or

lapsed, you must submit a Verification of Licensure form completed by the issuing jurisdiction.

You will be prompted to input the jurisdiction of the license/certifications(s) you hold, the number for

these license/certification(s), their status, and the type of license and certification. Click “Add” at the

bottom of the screen to add each entry to your application.

Step 17





information.



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Step 18



Step 19





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Step 20




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